The Effects of an Acute Maximal Seated Lumbar Spine Flexion Exposure on Low Back Mechanical Pain Sensitivity

2021 ◽  
pp. 1-8
Author(s):  
Daniel Viggiani ◽  
Jack P. Callaghan
Keyword(s):  
Lumbar Spine ◽  
Pain Sensitivity ◽  
Recovery Period ◽  
Low Back ◽  
Pain Thresholds ◽  
Pressure Algometry ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Sensitivity Changes ◽  
Neural Feedback

Viscoelastic creep generated in the lumbar spine following sustained spine flexion may affect the relationship between tissue damage and perceived pain. Two processes supporting this altered relationship include altered neural feedback and inflammatory processes. Our purpose was to determine how low back mechanical pain sensitivity changes following seated lumbar spine flexion using pressure algometry in a repeated-measures, cross-sectional laboratory design. Thirty-eight participants underwent a 10-minute sustained seated maximal flexion exposure with a 40-minute standing recovery period. Pressure algometry assessed pressure pain thresholds and the perceived intensity and unpleasantness of fixed pressures. Accelerometers measured spine flexion angles, and electromyography measured muscular activity during flexion. The flexion exposure produced 4.4° (2.7°) of creep that persisted throughout the entire recovery period. The perception of low back stimulus unpleasantness was elevated immediately following the exposure, 20 minutes before a delayed increase in lumbar erector spinae muscle activity. Women reported the fixed pressures to be more intense than men. Sustained flexion had immediate consequences to the quality of mechanical stimulus perceived but did not alter pressure pain thresholds. Neural feedback and inflammation seemed unlikely mechanisms for this given the time and direction of pain sensitivity changes, leaving a postulated cortical influence.

The tolerance to stretch is linked with endogenous modulation of pain

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Morten Pallisgaard Støve ◽  
Rogerio Pessoto Hirata ◽  
Thorvaldur Skuli Palsson
Keyword(s):  
Range Of Motion ◽  
Pain Sensitivity ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Static Stretch ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressor Test ◽  
Pressure Pain Thresholds ◽  
Exercise Induced

Abstract Objectives The effect of stretching on joint range of motion is well documented, and although sensory perception has significance for changes in the tolerance to stretch following stretching the underlining mechanisms responsible for these changes is insufficiently understood. The aim of this study was to examine the influence of endogenous pain inhibitory mechanisms on stretch tolerance and to investigate the relationship between range of motion and changes in pain sensitivity. Methods Nineteen healthy males participated in this randomized, repeated-measures crossover study, conducted on 2 separate days. Knee extension range of motion, passive resistive torque, and pressure pain thresholds were recorded before, after, and 10 min after each of four experimental conditions; (i) Exercise-induced hypoalgesia, (ii) two bouts of static stretching, (iii) resting, and (iv) a remote, painful stimulus induced by the cold pressor test. Results Exercise-induced hypoalgesia and cold pressor test caused an increase in range of motion (p<0.034) and pressure pain thresholds (p<0.027). Moderate correlations in pressure pain thresholds were found between exercise-induced hypoalgesia and static stretch (Rho>0.507, p=0.01) and exercise-induced hypoalgesia and the cold pressor test (Rho=0.562, p=0.01). A weak correlation in pressure pain thresholds and changes in range of motion were found following the cold pressor test (Rho=0.460, p=0.047). However, a potential carryover hypoalgesic effect may have affected the results of the static stretch. Conclusions These results suggest that stretch tolerance may be linked with endogenous modulation of pain. Present results suggest, that stretch tolerance may merely be a marker for pain sensitivity which may have clinical significance given that stretching is often prescribed in the rehabilitation of different musculoskeletal pain conditions where reduced endogenous pain inhibition is frequently seen.

scholarly journals Dynamic Pressure Pain Hypersensitivity as Assessed by Roller Pressure Algometry in Episodic Cluster Headache

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. 219-227
Author(s):  
César Fernández-de-las-Peñas
Keyword(s):  
Cluster Headache ◽  
Pain Sensitivity ◽  
Static Pressure ◽  
Dynamic Pressure ◽  
Pressure Algometry ◽  
Pressure Pain ◽  
Key Words Cluster Headache ◽  
Pressure Pain Thresholds ◽  
Preventive Medication ◽  
Pressure Algometer

Background: A method for assessing dynamic muscle hyperalgesia (dynamic pressure algometry) has been developed and applied in tension-type and migraine headaches. Objectives: To investigate differences in dynamic pressure pain assessment over the trigeminal area between men with cluster headache (CH) and headache-free controls, and the association between dynamic and static pressure pain sensitivity. Study Design: A case-control study. Setting: Tertiary urban hospital. Methods: Forty men with episodic CH and 40 matched controls participated. Dynamic pressure pain sensitivity was assessed with a dynamic pressure algometry set consisting of 8 rollers with different fixed levels (500, 700, 850, 1,350, 1,550, 2,200, 3,850, and 5,300 g). Each roller was moved at a speed of 0.5 cm/sec over a diagonal line covering the temporalis muscle from an anterior to posterior direction. The dynamic pressure threshold (DPT; load level of the first painful roller) and the pain intensity perceived at the DPT level (roller-evoked pain) were assessed. Static pressure pain thresholds (PPT) were also assessed with a digital pressure algometer applied statically over the mid-muscle belly of the temporalis. Patients were assessed in a remission phase, at least 3 months from the last cluster attack, and without preventive medication. Results: Side-to-side consistency between DPTs (r = 0.781, P < 0.001), roller-evoked pain on DPT (r = 0.586; P < 0.001), and PPTs (r = 0.874; P < 0.001) were found in men with CH. DPT was moderately, bilaterally, and side-to-side associated with PPTs (0.663 > r > 0.793, all P < 0.001). Men with CH had bilateral lower DPT and PPT and reported higher levels of rollerevoked pain (all P < 0.001) than headache-free controls. Limitations: Only men with episodic CH were included. Conclusions: This study supports that a dynamic pressure algometry is as valid as a static pressure algometry for assessing pressure pain sensitivity in patients with CH. Assessing both dynamic and static pain sensitivity may provide new opportunities for differentiated diagnostics. Key words: Cluster headache, dynamic pressure pain, pressure pain threshold

scholarly journals Pain thresholds and suprathreshold pain after sleep restriction in migraine – A blinded crossover study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110565
Author(s):  
Jan Petter Neverdahl ◽  
Martin Uglem ◽  
Dagfinn Matre ◽  
Johannes Orvin Hansen ◽  
Morten Engstrøm ◽  
...  
Keyword(s):  
Crossover Study ◽  
Pain Sensitivity ◽  
Sleep Restriction ◽  
Heat Pain ◽  
Healthy Controls ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Disturbed Sleep ◽  
Pressure Pain Thresholds ◽  
Lower Pain

Objective There is an unexplained association between disturbed sleep and migraine. In this blinded crossover study, we investigate if experimental sleep restriction has a different effect on pain thresholds and suprathreshold pain in interictal migraineurs and controls. Methods Forearm heat pain thresholds and tolerance thresholds, and trapezius pressure pain thresholds and suprathreshold pain were measured in 39 interictal migraineurs and 31 healthy controls after two consecutive nights of partial sleep restriction and after habitual sleep. Results The effect of sleep restriction was not significantly different between interictal migraineurs and controls in the primary analyses. Pressure pain thresholds tended to be lower (i.e., increased pain sensitivity) after sleep restriction in interictal migraineurs compared to controls with a 48-hour preictal-interictal cut-off (p = 0.061). We found decreased pain thresholds after sleep restriction in two of seven migraine subgroup comparisons: heat pain thresholds decreased in migraineurs with lower pain intensity during attacks (p = 0.005) and pressure pain thresholds decreased in migraineurs with higher severity of photophobia during attacks (p = 0.031). Heat pain thresholds tended to decrease after sleep restriction in sleep-related migraine (p = 0.060). Sleep restriction did not affect suprathreshold pain measurements in either group. Conclusion This study could not provide strong evidence for an increased effect of sleep restriction on pain sensitivity in migraineurs compared to healthy controls. There might be a slightly increased effect of sleep restriction in migraineurs, detectable using large samples or more pronounced in certain migraine subgroups.

Pressure pain thresholds in patients with chronic nonspecific low back pain

2016 ◽  
Vol 29 (2) ◽  
pp. 327-336 ◽  
Author(s):  
Marta Imamura ◽  
Fábio Marcon Alfieri ◽  
Thais Raquel Martins Filippo ◽  
Linamara Rizzo Battistella
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds
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